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Vendor Permit Application - Welcome to Broward County

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Vendor Permit Application - Welcome to Broward County Powered By Docstoc
					                                 Board of County Commissioners, Broward County, Florida
                                                                                                            VENDOR PERMIT ID
                                              Parks and Recreation Division                                      County Use Only




                                                 VENDOR PERMIT APPLICATION

Submit completed application to:        Broward County Parks and Recreation Division         ParksSafety@broward.org
                                        c/o Safety Section                                   Phone: 954-357-8172
                                                   th
                                        950 NW 38 Street                                     Fax:    954-357-8156
                                        Oakland Park, Florida 33309

Allow five (5) business days for processing from date of receipt.
Applications expire one (1) year from approval date.
Application fee due upon submittal and/or renewal.


                                               VENDOR OWNER INFORMATION
Company Name

Doing Business As (DBA)

Company Address

Company City, State, Zip

Contact Name

Business Phone

Cell Phone

Fax

E-Mail

Business Web Site

Type of Business
(Caterer, Performer, etc.)



SECTION 1: AUTHORIZED AMUSEMENT APPARATUS AND RIDES
(VENDOR TO VERIFY IF APPLICABLE)
             Date            Vendor Initials     Requirements
                                                 The following amusement apparatus and amusement rides are permitted within
                                                 Broward County Parks and Recreation Division (“Division”) sites. No other type of
                                                 apparatus or rides are permitted.
                                                         Bounce House/Inflatables up to 30 feet in height.
1.A                                                      Climbing Wall.
                                                         Reverse-bungee trampolines.
                                                         Kiddie Rides (limit 3 per event) (Defined as an amusement ride designed
                                                          primarily for use by patrons up to 12 years of age [Reference: Section
                                                          616.242, Florida Statutes, as may be amended from time to time]).
                                                 Amusement apparatus and/or rides are limited to single-day events only, including
1.B
                                                 set up and break down.



Form 501-201 Vendor Permit Application (12/10)                                                                                     Page 1
SECTION 1: AUTHORIZED AMUSEMENT APPARATUS AND RIDES
(VENDOR TO VERIFY IF APPLICABLE)
                                                 Vendor agrees to comply with all State of Florida Bureau of Fair Rides inspection
1.C                                              standards as listed at www.doacs.state.fl.us/standard/fairs/index.html including an
                                                 affixed USAID plate and decal.
                                                 The Division reserves the right to prohibit or limit the number of amusement
                                                 apparatus and/or amusement rides based on location (i.e., space at pavilions, specials
1.D                                              events areas, park, etc.) and may also limit the number of times per year events can
                                                 be held at a particular park. The Division may designate the area(s) or location(s)
                                                 where amusement apparatus and amusement rides are permitted.
1.E                                              Vendor is responsible for following manufacturers’ guidelines with regard to weather.
                                                 Vendor shall provide an attendant, age 16 or older, at all amusement apparatus
1.F                                              and/or amusement rides. Attendant must have valid photo identification on their
                                                 person while on park property.
                                                 Subcontracting to other vendors is permitted only to those vendors with an approved
1.G                                              and current Broward County Vendor Permit and an approved and current Certificate
                                                 of Insurance.
1.H                                              Vendor may not solicit wares to other park patrons on the day of Permitee’s event.
                                                 Vendor shall provide proof of State of Florida Inspection for each individual
1.I
                                                 amusement apparatus and Kiddie ride – Attach a Copy.



SECTION 2: ADA COMPLIANCE (VENDOR TO VERIFY)
            Date           Vendor Initials       Requirements
                                                 For private rentals/events that are not open to the public or advertised to the general
                                                 public, the Permitee will be responsible for providing modifications, accommodations,
2.A
                                                 and auxiliary aids and/or services that may be requested by or necessary for its
                                                 guests/invited attendees.
                                                 For rentals/events that are open to the public, the Permitee shall comply with Title I
                                                 and Title II of the Americans with Disabilities Act (ADA) in the course of providing any
2.B
                                                 services, programs, and/or activities regarding nondiscrimination on the basis of
                                                 disability, and all applicable regulations, guidelines, and standards.



SECTION 3: SOUND LEVELS (VENDOR TO VERIFY)
            Date           Vendor Initials       Requirements
                                                 All noise, music, and sounds must be kept to an acceptable level that does not
                                                 jeopardize the public’s health, welfare or safety, or degrade the quality of life of park
 3.                                              users and the community. An acceptable level of public noise, music, and sound will
                                                 be determined by the Broward County Parks and Recreation Division Director or
                                                 designee. NOTE: Not all parks allow amplified sound.



SECTION 4: “AS WAS” CONDITION (VENDOR TO VERIFY)
            Date          Vendor Initials    Requirements
                                             Vendor agrees to return event site to Broward County Parks and Recreation Division in
                                             an “as was” condition. Vendor shall be responsible for repair or cost of repairs for
 4.                                          damage to the event site caused by the Vendor and/or its sub-contractors before and
                                             during the event, and until fully vacated (including, but not limited to turf and
                                             vegetation, facilities, irrigation, electrical, water, etc.).




Form 501-201 Vendor Permit Application (12/10)                                                                                       Page 2
SECTION 5: EVENT NOTIFICATION AND PARK ACCESS (VENDOR TO VERIFY)
            Date          Vendor Initials    Requirements
                                             Vendor agrees to notify the respective park, at least forty-eight (48) hours in advance
                                             of an event, in person, fax, or via e-mail, regarding which amusement apparatus,
 5.
                                             amusement rides and/or services they will be providing. The Park, in turn, will
                                             acknowledge approval by providing Vendor access pass(es) for the event date only.



SECTION 6: FDLE SEXUAL OFFENDER/PREDATOR CHECK (VENDOR TO VERIFY)
           Date              County              Requirements
         Reviewed         Verification by
                                                 Vendor must ensure that its employees, volunteers, and independent contractors,
                                                 working with or around children are not listed on the FDLE Sexual Offender/Predator
 6.                                              database, located at www.fdle.state.fl.us or on the United States Department of
                                                 Justice, National Sex Offender Public Website located at www.nsopw.gov. Attach
                                                 Vendor Criminal Background Screening Affidavit.



SECTION 7: INSURANCE/LICENSE (VENDOR TO PROVIDE)
           Date              County              Requirements
         Reviewed         Verification by
                                                 Certificate of Insurance must have Broward County Board of County Commissioners
7.A                                              named as an additional insured and as a Certificate Holder with the address of 950
                                                          th
                                                 N.W. 38 Street, Oakland Park, Florida, 33309. Attach a Copy.
                                                 Current Comprehensive General Liability Policy:
                                                 $______________ Minimum $500,000 *except for clowns & DJ’s+ Refer to current
                                                 insurance requirements for proper limits.
7.B                                              $______________ When applicable, minimum $500,000 products liability for all food
                                                 vendors.
                                                 $______________ When applicable, additional minimum $500,000 liquor liability for
                                                 beer and wine.
                                                 Certificate of Insurance must be signed by insurance company’s authorized
7.C
                                                 representative.
                                                 Endorsement from insurance company’s authorized representative identifying the
7.D                                              type(s) of equipment, amusement apparatus, and amusement rides insured under the
                                                 policy.
                                                 Vendor shall provide valid Broward County Local Business Tax Receipt – Attach a
7.E
                                                 Copy.



SECTION 8: VENDOR APPLICATION FEE (VENDOR TO PROVIDE)
           Date              County              Requirements
         Reviewed         Verification by
                                                 Vendor Application Fee: Pursuant to Chapter 5, Part VIII, Section 5.41 of the Broward
                                                 County Administrative Code, “Parks System Fee Schedule,” the Vendor is required to
 8
                                                 submit, at the time of application and/or renewal, a Vendor Application Fee in the
                                                 amount set forth in the Parks System Fee Schedule.




Form 501-201 Vendor Permit Application (12/10)                                                                                   Page 3
SECTION 9: OWNER ACKNOWLEDGEMENT (VENDOR)
                          I do hereby knowingly, freely, and voluntarily assume all liability for any damage or injury that may
                          occur as a result of my and/or my representative’s participation as a Vendor in event(s) to be held at a
                          Broward County park and agree to release, waive, discharge, and covenant not to sue Broward County,
                          its officers, agents, employees, and volunteers (all for the purposes herein referred to as the
                          “Releasees”) from any liability or claims for damage or injury that may be sustained by me or a third
                          party directly or indirectly in conjunction with, or arising out of, my or my company’s participation in
                          the event(s), where caused in whole or in part by the negligence of Broward County or the Releasees.
                          I, further agree to indemnify and hold harmless the Releasees with respect to any and all liability
                          including all fees, costs, expenses, and attorney’s fees, resulting from losses sustained by third parties,
                          arising out of my actions or alleged actions of my company, its officers, agents, and employees, in
                          connection with participation as a Vendor at the event(s). I do hereby grant full permission to Broward
                          County to use photographs, videotapes, recordings, and any other record of the activity for any
                          legitimate purpose whatsoever.

                          Vendor acknowledges that a violation of a Broward County Ordinance and/or Administrative Code
                          provision may result in the revocation of this Permit and the ability to conduct business within Broward
                          County Parks and Recreation Division areas for a period of one (1) calendar year from date of
                          notification.
DATE                      (PRINT NAME)                                      (SIGNATURE)




SECTION 10: SIGNATURE OF APPROVAL (COUNTY USE ONLY)
Director or Designee      (PRINT NAME)                                      (SIGNATURE)

DATE




Form 501-201 Vendor Permit Application (12/10)                                                                                  Page 4

				
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